Wednesday, October 27, 2010

SmokeFree Wisconsin Misleading Public about Orbs risk

SmokeFree Wisconsin posted a convincing blog post implying to consumers that Camel Orbs carry a high risk of cancer, based on facts culled from a CDC report on smokeless tobacco.

What SmokeFree Wisconsin fails to tell consumers is that report is based on old-fashioned chew and snuff, NOT newer products such as lozenges, strips, sticks and snus.

Stating simply that "smokeless tobacco contains 28 known, cancer-causing toxins," is misleading and a half-truth. The CDC made this declaration about chew and snuff based mostly on a 2007 WHO report, "Smokeless Tobacco and Some Tobacco-specific N-Nitrosamines." The tobacco products they analyzed were not the refined, fine tobacco used in Orbs and other newer smokeless tobacco products. The same levels of nitrosamines (TSNAs) found in those products have not been found in products such as Orbs and snus.

In fact, in June 2010, the Canadian Non-Smokers' Rights Association endorsed tobacco harm reduction, including the use of products such as Orbs, snus and electronic cigarettes. They released NSRA Harm Reduction Policy Analysis June-2010* which showed the true risks of cancer associated with such products were minimal, if not non-existent. Mind you - this is a report by an organization concerned for non-smokers' rights:

The risk of oral cancer varies by type of smokeless tobacco product and is much greater for dry snuff than for moist snuff. The relative risk of oral cancer from use of dry snuff is 5.9 compared to 1.2 from chewing tobacco and 1.0 from moist snuff.37 A meta-analysis in 2007 concluded that the type of smokeless tobacco used in America or Europe “carriesat most a minor increased risk of oral cancer.”38 The Royal College of Physicians has concluded that “the risk of oral cancer associated with use of low-TSNA tobacco products such as Swedish snus is small, and possibly non-existent.”39

The report also warns that comparing products such as snus and Orbs with smokeless chew and snuff are misleading:

When considering studies of the health risks of smokeless tobacco, it is important to distinguish between smokeless products such as traditional spit and chew (in Canada the most popular brands are Copenhagen and Skoal) and Swedish-style snus. Most studies of the health risks of smokeless tobacco use do not make the distinction between snus and other forms of smokeless tobacco.

• Oral cancer

– The risk of oral cancer varies according to the type of smokeless tobacco. Two Swedish studies found no elevated risk of oral cancer from snus use, and the findings constituted the grounds for the removal of the oral cancer warning from snus products in Sweden in 2001.50

• Leukoplakia

– There is a very high rate of leukoplakia development from snus use, much higher than with other forms of smokeless tobacco; however, the lesions are mostly due to irritation and only rarely progress to oral cancer.51

• Heart disease

– There are very few studies of the risk of heart disease from use of Swedish snus that also correct for possible confounding variables, including smoking and exposure to second-hand smoke. Of six studies of risks of heart attack risk among long-term Swedish snus users, only one found an increased risk, and five found no increased risk over never tobacco users.52 A meta-analysis in 2009 of eleven studies, eight in Sweden and three in the US, provides consistent evidence of a small increase in risk of fatal heart attack and stroke, with no evidence of a difference in effect of the smokeless products.

The report goes on to discuss lozenges very similar to Orbs:

Small manufacturer Star Scientific has been selling two forms of dissolvable tobacco product for several years—Ariva, targeting cigarette smokers, and Stonewall, aimed at users of smokeless tobacco. Both products come in the form of a small pellet, slightly larger than a Tic Tac mint.59

Ariva and Stonewall have levels of TSNAs similar to Swedish snus.60

While the pellets may contain higher amounts of nicotine, the average nicotine user tends to "self-regulate" and would simply use less pellets than they would smoke. The craving for nicotine subsides after exposure, so the user would be less likely to use as many Orbs as they would cigarettes. Additionally, the nicotine content in cigarettes varies just as widely and the low nicotine content in NRTs such as nicotine gums, lozenges and patches make them highly ineffective as a substitute for smoking.

Of course, none of these products should be in the hands of children, but claiming that these products are "not a safe alternative to cigarettes" belies the truth that they are a SAFER alternative to smoking and misleads the public into believing that smokers would not have any health benefit by switching. However, even if these smokeless products still have a 1-2% risk of adverse health effects, that still makes them 98-99% less risky than smoking.

As the Canadian report urges:

The public has the right...to accurate information about the relative risks of using tobacco products and to make choices based on the facts. The current warning on smokeless tobacco products, “This product is not a safe alternative to smoking,” is woefully inadequate as it provides no information regarding relative risks.

SmokeFree Wisconsin apparently believes that Wisconsin consumers do not deserve the same right.

If SmokeFree Wisconsin is truly concerned about nicotine products getting into the hands of children, they should also warn parents of another candy-like nicotine product. This product is white (Orbs are brown) and looks EXACTLY like a Tic Tac. They even have those "quitting sucks" commercials with a shark attack and other humorous scenarios that kids think are funny.

3 comments:

Those mini Nicorette lozrenges sure look a lot more like tic tacs and the brown orbs and they come in Mint flavor, a favorite of children, I'm sure.

When organization like Smokefree Wisconsin learn to be honest in their approach, perhaps people will listen. Right now, they appear more willing to protect their money stream by promoting Pharmaceutical products and keeping people on cigarettes.

No one is going to be smoke free, Wisconsin if you keep trying to take away harm reduction products. Frankly, the Camel Orbs look like scat so I seriously doubt any kids are going to want to put those in their mouth. Those products should be behind sale counters anyways so as not to be sold to minors...

Thanks for the clarification and whole truth about the outdated CDC report.

Personally I think its about time someone brought a lawsuit up against these groups for public endangerment with the tools from SFW on the top of list. You may not win but at least you would get there attention.

About the Author

Kristin Noll-Marsh is vice president of the Consumer Advocates for Smoke-free Alternatives Association. CASAA is a non-profit organization that works to ensure the availability of reduced harm alternatives to smoking and to provide smokers and non-smokers alike with truthful information about such alternatives.

This blog is Kristin's personal views and opinions and does not represent the views or policies of CASAA.